Construction Solutions - Masonry, Cement & Plaster - Spreading, leveling, and smoothing concrete, mortar or terrazzo mixtures



Hazard Analysis


	Work Activity:	Masonry, Cement & Plaster
	Task:	Spreading, leveling, and smoothing concrete, mortar or terrazzo mixtures
	Hazard:	Skin contact with chemicals

Problem:

Dermatitis and other skin disorders.

Workers who are exposed to portland cement and portland cement containing products can get occupational skin disease. The occupational skin disease can include irritation, irritant contact dermatitis, allergic contact dermatitis and caustic burns.

Risk Description:

Cement is caustic and prolonged contact with wet cement will cause skin irritation and burns. Cement contains chromate, which causes allergic dermatitis. Other masonry materials are abrasive and irritating to the skin and increase the likelihood of developing an allergy.

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The skin is the single largest organ. It covers 20 square feet of surface. The skin's purpose is to protect the body from outside substances, chemicals and bacteria. The skin has two layers, together both are less than 1/8-inch thick. The dermis is only 1/50th to 3/25th of an inch thick.

Worksite materials can cause skin problems. Some materials ‘insult’ and injure skin. Some pass through it into the bloodstream. Examples of these materials are:

Portland cement

hygroscopic

Sensitizers in workplace materials may cause an allergic response. The reaction may be local or widespread. Sensitization is an immune response. The immune system fights a foreign substance. Usually, the material causes no change on first contact. Once a person is sensitized, small amounts can trigger a strong reaction. Many people cannot tolerate further exposure.

Possible sensitizers used by construction workers include: hexavalent chromium (Cr6+ ) in cement, chemical admixtures in concrete, epoxies, additives in rubber gloves, and other trace metals in cement products.

Hexavalent chromium (Cr₆₊) is a sensitizer. It is an important cause of allergic contact dermatitis. Cement’s alkalinity increases skin absorption of this soluble chromate. Some studies show that Cr6+ penetrates the skin and enters the bloodstream.

Worksite cleaners too often are caustic and abrasive. They also may contain sensitizers like lanolin, limonene, or perfume and irritants like alcohol.

Worksite conditions can determine whether a worksite material will cause skin problems.

How long does the material contact the skin?
How often does a worker use the material?
Is there mechanical trauma or abrasion of the skin (a break in the barrier)?
Is the material trapped or occluded to the skin with gloves, creams, lotions, petroleum jelly, or barrier creams?
Are there adequate hygiene facilities?

Environmental factors can cause skin problems directly or they can work with other factors to increase skin problems:

Heat causes sweating. Sweat dissolves chemicals and brings them into closer contact with the skin. Heat increases blood flow at the skin surface and increases absorption of materials into and through the skin.
Cold dries the skin and causes microscopic cracks. Cold changes blood flow at the skin surface and leads to loss of feeling.
Humidity increases sweating. High humidity keeps sweat from evaporating. Extremely low humidity can dry skin as sweat evaporates.
Sun burns and damages skin. Sun can increase absorption of chemicals. Sun reacts with some chemicals to cause photosensitization.

Individual factors can affect work-related skin problems. These include:

pre-existing dermatitis
genetic predisposition
knowledge
attitude
personal behavior/work practices

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Level of Risk:

Exposures are of such a magnitude and character that a significant number of workers risk developing serious long or short term health effects.

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Assessment Info:

Some tools you can use to measure the risk for dermatitis in this task, where skin contact with mortar and cement is common, include observation to see how much skin contact occurs, asking workers about skin symptoms, and pH tests of surface skin.

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Here are some tools you can use to measure the risk for dermatitis, and find ways to reduce the risk. You might also think of other tools.

Observations and reports of work/personal practices
Symptoms checklist
pH tests of surface skin

Consider comparing your group of workers with themselves before and after beginning a program to reduce dermatitis (see solutions). Use written checklists. Watch your employees work and take reports from them of what they do to are compare a group before and after. Which best practices are the employees currently doing? Which are they failing to do? Keep a written record of observations. Have employees complete a symptoms checklist of the skin problems they currently have, with no names attached. Ask them to do a pH test of surface skin. Once you have a baseline record, then begin the effort to reduce skin problems. Take the same measurements periodically to assess progress. The results can help you adjust the efforts.

Best Practices Checklist



___ 1. Wash with clean running water and pH-neutral soap.
___ 2. Wear correct gloves.
___ 3. Wash before putting on gloves.
___ 4. Wash again whenever gloves are removed.
___ 5. Use disposable gloves or clean reusable gloves daily.
___ 6. Remove gloves properly.
___ 7. Wear glove liners.
___ 8. No jewelry at work.
___ 9. Long sleeves buttoned or taped inside gloves.
___ 10. Rubber boots with pants taped inside for concrete work.
___ 11. Never let cement remain on skin or clothes.
___ 12. Avoid barrier creams
___ 13. Avoid skin softening products at work.
___ 14. Change out of work clothes before leaving jobsite.
___ 15. See a doctor for any persistent skin problem

Symptoms Checklist

___ 1.	Check if you had at least one skin problem during the last 12 months
___ 2.	Check if you currently have the skin problem.
___ 3.	If you have a skin problem, check all the words that apply
	___ redness
	___ burning
	___ blisters
	___ fissures
	___ oozing
	___ bumps/papules
	___ scaling or peeling or dead skin
	___ other (describe):
	___ stinging
	___ pain
	___ itching
	___ bleeding
	___ rash

SURFACE SKIN pH TESTING

Palm	pH ___	Palm	pH ___
Between Fingers	pH ___	Between Fingers	pH ___
Back of Hand	pH ___	Back of Hand	pH ___
Date	______	Date	_____

pH indicator papers make it easy to get reasonably accurate measurement of pH on skin surfaces, car interior surfaces, and other places. To test skin or dry surfaces, moisten the indicator in distilled water. Then apply it to the test surface. To test a liquid, dip the indicator in the liquid. Full range indicator papers (pH 1 to 14) work best for cement.

Normal skin is pH 4.5 to 5.5, meaning it is moderately acidic. Contact with wet cement changes skin pH to alkaline. At alkaline pH, skin barrier repair is slowed, damage is prolonged, and skin problems are worsened. Testing skin pH will help determine if the worker or workers are at risk for contact dermatitis.

References

An Employer's Guide to Skin Protection (May be helpful to print this guide)
NIOSH Skin Page
Skin Conditions Physicians Alert

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Solutions:

For Designers

For Manufacturers

For Contractors

Good Work Practices for Working with Cement

For Workers

Suggest a Solution

Regulations & Standards:

See Regulations & Standards Detail